gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Validation of the baseline severity stratification of objective functional impairment in lumbar degenerative disc disease

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  • Martin N. Stienen - Klinik für Neurochirurgie, UniversitätsSpital Zürich, Zürich, Switzerland
  • Nicolas R. Smoll - Newcastle, Australia
  • Holger Joswig - St.Gallen, Switzerland
  • Marco-Vincenzo Corniola - Genève, Switzerland
  • Karl Schaller - Hôpitaux Universitaires de Genève, Neurochirurgie, Genève, Switzerland
  • Gerhard Hildebrandt - St.Gallen, Switzerland
  • Oliver P. Gautschi - Genf, Switzerland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDi.01.07

doi: 10.3205/17dgnc183, urn:nbn:de:0183-17dgnc1830

Published: June 9, 2017

© 2017 Stienen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: The Timed Up and Go (TUG) test is a simple, objective and standardized measure for objective functional impairment (OFI) in patients with lumbar degenerative disc disease (DDD). The objective of the current work was to validate the OFI baseline severity stratification (BSS).

Methods: Data was collected in a prospective IRB-approved two-center study. Patients were assessed with a comprehensive panel of pain (Visual analogue scale (VAS) for back and leg pain), functional impairment (Roland-Morris (RMDI) and Oswestry Disability Index (ODI)) and health-related quality of life (hrQoL; Euro-Qol (EQ-5D), Short Form (SF)-12) measures. OFI BSS was determined using age- and sex-adjusted cut-off values.

Results: N=375 consecutive patients scheduled for lumbar spine surgery were included. Each 1-step increase on the OFI BSS corresponded to an increase of VAS back pain of 0.53, VAS leg pain of 0.69, 1.81 and 5.93 points on the RMDI and ODI, as well as to a decrease of hrQoL of -0.073 on the EQ-5D, -1.99 on the SF-12 physical component summary (PCS) and -1.62 on the SF-12 mental component summary (MCS; all p<0.001). Patients with mild, moderate and severe OFI had increased leg pain by 0.90 (p=0.044), 1.54 and 1.94 (p<0.001), increased ODI by 7.99 (p=0.004), 12.64 and 17.13 (p<0.001) and decreased SF-12 PCS by -2.57 (p=0.049), -3.63 (p=0.003) and -6.23 (p<0.001), respectively.

Conclusion: The OFI BSS is a valid measure of functional impairment for use in daily clinical practice. The presence of OFI indicates the presence of significant functional impairment on subjective outcome measures.